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Simple Pneumonia and Pleurisy with complications
Medicare DRG 194. What hospitals charge and what Medicare pays, 2024.
Avg hospital charge
$38,466
Avg total payment
$7,905
Avg Medicare pays
$5,904
Hospitals reporting
1,511
The "charge" is the hospital's list price — almost nobody pays it. "Total payment" is what the hospital actually received (Medicare plus patient copays and other payers). These figures cover Medicare fee-for-service inpatient stays only.
| State | Hospitals | Avg charge | Avg Medicare payment |
|---|---|---|---|
| Nevada | 11 | $80,886 | $6,107 |
| California | 107 | $71,019 | $7,651 |
| New Jersey | 49 | $70,566 | $6,152 |
| Colorado | 9 | $59,839 | $5,360 |
| Florida | 119 | $54,509 | $5,622 |
| Texas | 94 | $47,224 | $6,467 |
| New York | 92 | $41,361 | $7,377 |
| Arizona | 26 | $39,276 | $5,833 |
| Pennsylvania | 79 | $38,970 | $5,124 |
| Hawaii | 3 | $38,053 | $7,447 |
| Tennessee | 33 | $36,742 | $4,895 |
| Alaska | 3 | $35,929 | $12,764 |
| Georgia | 45 | $35,490 | $6,092 |
| Washington | 14 | $35,233 | $5,884 |
| Oklahoma | 30 | $35,084 | $5,615 |
| South Carolina | 33 | $34,966 | $5,286 |
| District of Columbia | 2 | $34,582 | $5,731 |
| New Mexico | 4 | $34,276 | $6,018 |
| Mississippi | 25 | $33,352 | $5,236 |
| Illinois | 67 | $33,305 | $5,373 |
| Kansas | 14 | $32,913 | $4,790 |
| Connecticut | 18 | $32,063 | $6,687 |
| Virginia | 42 | $31,684 | $5,276 |
| South Dakota | 4 | $30,685 | $5,418 |
| Indiana | 49 | $30,633 | $5,328 |
| Missouri | 37 | $30,358 | $5,209 |
| Kentucky | 27 | $30,203 | $4,579 |
| Louisiana | 32 | $30,112 | $4,803 |
| Nebraska | 7 | $30,047 | $5,374 |
| North Carolina | 48 | $29,143 | $5,674 |
| Oregon | 8 | $28,305 | $6,660 |
| Arkansas | 23 | $28,207 | $4,750 |
| Wisconsin | 23 | $28,167 | $5,202 |
| Ohio | 71 | $27,764 | $4,978 |
| Alabama | 36 | $27,505 | $5,107 |
| West Virginia | 17 | $26,922 | $4,627 |
| Wyoming | 5 | $26,341 | $7,620 |
| New Hampshire | 9 | $26,332 | $5,568 |
| Utah | 2 | $26,222 | $5,433 |
| Delaware | 5 | $25,899 | $5,876 |
| Rhode Island | 7 | $25,045 | $5,857 |
| Iowa | 15 | $24,963 | $4,777 |
| Idaho | 1 | $23,232 | $5,009 |
| Maine | 7 | $23,089 | $5,857 |
| Michigan | 42 | $22,991 | $5,276 |
| Minnesota | 25 | $22,907 | $5,491 |
| Vermont | 3 | $22,776 | $5,216 |
| North Dakota | 4 | $19,931 | $4,689 |
| Montana | 2 | $18,944 | $5,163 |
| Massachusetts | 46 | $18,818 | $6,315 |
| Maryland | 37 | $13,027 | $10,127 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service. A DRG (Diagnosis Related Group) is how Medicare classifies an inpatient stay for payment; the description is Medicare's, not a diagnosis for any individual.